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ORIGINAL RESEARCH article

Front. Nephrol.
Sec. Critical Care Nephrology
Volume 4 - 2024 | doi: 10.3389/fneph.2024.1470926

Nephrology intervention to avoid acute kidney injury in patients awaiting cardiac surgery: randomized clinical trial

Provisionally accepted
Sergi Codina Sergi Codina 1*Laia Oliveras Laia Oliveras 1Eva Ferreiro Eva Ferreiro 1Aroa Rovira Aroa Rovira 2Ana Coloma Ana Coloma 1NURIA LLOBERAS NURIA LLOBERAS 3Edoardo Melilli Edoardo Melilli 1Miguel Hueso Miguel Hueso 1,3Farbizio Sbraga Farbizio Sbraga 1Enric Boza Enric Boza 1José M. Vazquez José M. Vazquez 4José L. Pérez-Fernández José L. Pérez-Fernández 1Joan Sabater Joan Sabater 1Josep M. Cruzado Josep M. Cruzado 1,3Nuria Montero Nuria Montero 1*
  • 1 Bellvitge University Hospital, Barcelona, Spain
  • 2 Hospital de vinaros, Vinaros, Spain
  • 3 Institut d'Investigacio Biomedica de Bellvitge (IDIBELL), Barcelona, Catalonia, Spain
  • 4 Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain

The final, formatted version of the article will be published soon.

    Introduction: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a well-known complication that increases morbidity and mortality rates. The objective of this study was to reduce CSA-AKI through nephrologist intervention in patients awaiting cardiac surgery.We performed a single center, open-label, randomized clinical trial including 380 patients who underwent scheduled cardiac surgery at the Hospital de Bellvitge between July 2015 and October 2019. A total of 184 patients were evaluated by the same Nephrologist one month before the surgery to minimize the risk factors for AKI. In addition to assessments at the outpatient clinic, we also collected clinical data during hospitalization and during the first year.Results: Despite the intervention, no differences were observed between the groups in the incidence of CSA-AKI (intervention group 26.37% vs. standard of care 25.13%, p=0.874), mortality (3.91% vs.3.59%, p=0.999), length of Intensive Care Unit (ICU) stay (10 days [7.00;15.0] for both groups, p=0.347), or renal function after one year of follow-up (estimated glomerular filtration rate (eGFR) by CKD-EPI: 74.5 ml/min (standard deviation 20.6) vs 76.7 (20.8) ml/min, respectively, p=0.364). A reduction in the need for blood transfusion was observed in the intervention group, although the difference was not statistically significant (37.22% vs. 45.03%, p =0.155).In this clinical trial, nephrologist intervention in the entire population on the cardiac surgery waiting list did not show a nephroprotective benefit.

    Keywords: Acute Kidney Injury, cardiac surgery, Nephrology intervention, clinical trials, Intensive Care

    Received: 26 Jul 2024; Accepted: 09 Oct 2024.

    Copyright: © 2024 Codina, Oliveras, Ferreiro, Rovira, Coloma, LLOBERAS, Melilli, Hueso, Sbraga, Boza, Vazquez, Pérez-Fernández, Sabater, Cruzado and Montero. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Sergi Codina, Bellvitge University Hospital, Barcelona, Spain
    Nuria Montero, Bellvitge University Hospital, Barcelona, Spain

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